Promoting Outpatient Medication Safety In Collaboration With Community Pharmacies And Other Healthcare Providers – What Kind Of Research We Need?

• By: MäKINEN, Emilia Emmi Maria (University of Helsinki, Finland)
• Co-author(s): Ms Emilia Emmi Maria Mäkinen (University of Helsinki, Helsinki, Finland)
  Mrs Anna-Kaisa Taimi (University of Helsinki, Helsinki, Finland / Pharmacy Lielahti, Tampere, Finland)
  Dr. Anna Schoultz (Pharmacy Kaari, Helsinki, Finland)
  Dr. Charlotta Sandler (The Association of Finnish Pharmacies, Helsinki, Finland)
  Prof. Anna-Riia Holmström (University of Helsinki, Helsinki, Finland)
  
• Abstract:

  Background information: Medication errors are one of the most endangering factors for patient safety, which has become a key target for improvement in health services systems worldwide. The most current development needs are related to outpatient care; however, up-to-date, medication safety research and improvement activities have primarily focused on hospital environments. To promote medication safety in outpatient care, the expertise of community pharmacies could be more effectively utilized. This study was carried out as part of the six-year National Medication Safety Programme of Community Pharmacies in Finland.
  
  Purpose: To explore the current national research needs to promote medication safety as a collaborative action by community pharmacies and other health and social care providers in Finnish outpatient care.
  
  Method: The study applied a modified qualitative Nominal Group Technique (NGT). A group of Finnish patient and medication safety experts (n=43) were invited to participate. The study comprised the following phases:
  1) Study introduction in an online meeting,
  2) Electronic survey for silent generation of research needs,
  3) Online group discussion involving "a round robin",
  4) Electronic Delphi survey for ranking of the most important research needs.
  Phases 2-4 were used for the data collection. The collected data were analysed by qualitative inductive content analysis by ATLAS.ti software.
  
  Results: Altogether 28 experts divided into four groups participated in the study. Five main themes with 22 sub-categories of research needs were identified, on which the research on promoting outpatient medication safety should focus in Finnish community pharmacies and health services system in the future. The main themes and their respective prioritization points were:
  1) Safe and seamless clinical pathways in outpatient care (n=372/1540),
  2) Medication safety collaboration between community pharmacies and other health and social care providers (n=361/1540),
  3) Promoting the safety of work processes in community pharmacies (e.g., monitoring and improving the safety of medication dispensing) (n=317/1540),
  4) Reporting of and learning from medication safety incidents in outpatient care as a tool for risk management (n=262/1540),
  5) Medication counselling and other community pharmacy services that improve medication safety (n=228/1540).
  
  Conclusion: The current research needs for promoting the medication safety of outpatients in collaboration with community pharmacies and other care providers covering a wide range of areas from strengthening clinical pathways to ensuring internal medication safety processes in community pharmacies. More research is especially needed on how to integrate community pharmacies more efficiently into medication safety risk management of outpatients. The results of the present study will be used in developing a national medication safety research strategy as a part of the National Medication Safety Programme of Community Pharmacies in Finland.